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Namkee G. Choi
Adult day care centers provide important health, social, and support services for functionally and cognitively impaired adults and their caregivers. The adult day care services are underutilized, however, because of the shortage of centers, caregivers' lack of awareness of and resistance to using services, and the mismatch between the needs of potential consumers and their informal caregivers and the services provided by the centers. To foster and support the expansion of adult day care centers, lessons learned from national demonstration programs need to be disseminated, and social workers need to be trained to provide essential services at the centers.
Patricia Brownell and Joanne Marlatt Otto
Adult Protective Services (APS) are empowered by states and local communities to respond to reports and cases of vulnerable adult abuse, neglect, and self-neglect. While incorporating legal, medical, and mental health services, APS programs are part of the social services delivery system and incorporate principles and practices of the social work profession.
Various models and theories of adult development exist but they are more assumptions about development than theories. The most popular age and stage theories have lost favor to contextual theories that put more emphasis on interaction with the environment. It has also become recognized that adults are a diverse group and do not follow universal stages of development. The usefulness of chronological age is also questionable as it does not tell us much about any particular person. Instead, we have to know their concerns and the events they are dealing with, and their dreams and aspirations.
This article presents information about group settings that provide residential long-term care for older adults, focusing on nursing homes and residential care/assisted living communities. It provides an overview of both settings and describes their scope of services, funding, and clientele. The section “Issues in Residential Long-Term Care” addresses issues of special relevance to social workers: dementia and other psychosocial care needs; quality of life and quality of care; access to and disparities in care; end-of-life care; family involvement; and abuse and neglect. The article ends with a section on the role of the social worker in residential long-term care.
Safeguarding is an area of social work activity concerned with the care and protection of children or adults who have care and support needs and who may be at risk of abuse or neglect. This is a major concern for social workers who usually have prime responsibility for ensuring as far as possible that the vulnerable clients they work with are protected. People’s ability to keep themselves safe is partly determined by their individual circumstances, and this may change at different stages in their life, so it is important that safeguarding is always considered in relation to the wishes of the person concerned. Effective safeguarding depends on a careful consideration of the factors involved and will almost always involve a multi-agency partnership approach. This article will primarily examine the situation regarding safeguarding vulnerable adults in the United Kingdom.
Meredith Stensland, Sara Sanders, and Marla Berg-Weger
Advance care planning (ACP) is the process of determining and documenting desired wishes for the end of one’s life. Referred to by such terms as end-of-life planning, advance (health) directives, and living wills, ACP is a relatively new concept within our society, having emerged as a social, political, and ethical issue in the United States only since the 1960s. Researchers and legislators have been challenged in their efforts to examine healthcare decision-making and design appropriate policy to guide practice. This article will define ACP, provide an overview of the history and evolution of the process and the associated legal and ethical issues, and describe the process with three specific populations. In addition, it examines the role of the social work profession in working with individuals and families on planning for the end of one’s life.
Definitions of what constitutes advanced statistical analysis often differ among social-work researchers and across disciplines. In this article, the term advanced statistical analysis refers to advanced models increasingly applied to social-work research that help address important research questions. Because contemporary statistical models fully rely on the maximum likelihood (ML) estimator, this article begins with an overview of ML that serves as a foundation for understanding advanced statistical analysis. Following the overview, the article describes six categories of analytic methods that are important in confronting a broad range of issues in social-work research (that is, hierarchical linear modeling, survival analysis, structural equation modeling, propensity score analysis, missing data imputation, and other corrective methods for causal inference such as instrumental variable approach and regression discontinuity designs). These analytic methods are used to address research issues such as generating knowledge for evidence-based practices; evaluating intervention effectiveness in studies that use an experimental or quasi-experimental design; assessing clients’ problems, well-being, and outcome changes over time; and discerning the effects of policies.
Robert L. Schneider, Lori Lester, and Julia Ochieng
Social work advocacy is “the exclusive and mutual representation of a client(s) or a cause in a forum, attempting to systematically influence decision-making in an unjust or unresponsive system(s).” Advocacy was identified as a professional role as far back as 1887, and social workers consider client advocacy an ethical responsibility. Social workers are increasing the use of electronic advocacy to influence client issues and policy development. As client and societal needs evolve, universities should emphasize advocacy in their curricula, and the National Association of Social Workers should promote electoral and legislative initiatives that reflect an emphasis on social and economic injustices.
Stephen H. Gorin, Julie S. Darnell, and Heidi L. Allen
This entry describes the development and key provisions of the Patient Protection and Affordable Care Act (ACA), which instituted a major overhaul of the U.S. health system, much of which took effect in 2014. The key provisions of the ACA included an individual mandate to purchase insurance, an employer mandate to offer coverage to most workers, an expansion of Medicaid to all persons below 138 percent of the federal poverty level (FPL), minimum benefit standards, elimination of preexisting condition exclusions, and reforms to improve health-care quality and lower costs. This historic legislation has deep roots in U.S. history and represents the culmination of a century-long effort to expand health care and mental health coverage to all citizens.
Larry E. Davis, John M. Wallace Jr., and Trina R. Williams Shanks
African Americans have been a part of the nation's history for nearly four hundred years. Although their history includes the forced imposition of chattel slavery, the strict enforcement of legal segregation, and a tenuous acceptance as equal citizens, African Americans have been, and continue to be, major contributors, creators, investors, and builders of America. In this article we summarize briefly the history of African Americans, we examine racial disparities in key indicators of social, mental, and physical well-being, and we highlight persistent strengths that can be built upon and areas that provide hope for the future. The challenge for social work is to simultaneously celebrate the historical successes and ongoing contributions of African Americans to this country while also recognizing the vestiges of structural racism and fighting for greater civil rights and social and economic justice.
Fariyal Ross-Sheriff and Tamarah Moss-Knight
The number and percentage of immigrants and refugees from Africa to the United States have increased substantially since the mid-1990s. Though still a relatively small percentage of the immigrant population, immigrants from Africa encounter many challenges that are important for social work professionals to address. This entry examines two groups of immigrants from Africa: legal migrants (immigrants) and refugees. It provides information on distinctive characteristics of recent African immigrants, reasons for emigration from Africa, challenges they face in the United States, and their settlement (geographical distribution) patterns. While black Africans are the focus of this entry, the research literature does not provide clear distinctions within the group of African immigrants. The emphasis is on black African immigrants to the United States as their experience is unique in terms of their race in America and the types of stigma and discrimination they face as a result. Critical issues for social work practice are examined through a case example of Somali refugees, followed by implications for social work practice and research.
Sharon E. Moore
African Americans number about 35 million or 12% of the U.S. population. Their life expectancy is lower than that of White Americans, and despite the educational gains made since mid-1980s, the unemployment gap between African Americans and Whites has increased. Similarly, although the number of African Americans working in white-collar occupations has increased, the disparity in wage earnings between African American and White workers continues. Regardless of social class African Americans are made to be cognizant of their race at all times. Today they are still at risk for social issues such as substance abuse, teen pregnancy, incarceration, poverty, high rates of female headed households, infant mortality that is twice as high as Whites, residential segregation, racism, and discrimination. As daunting as these problems are, the strengths of the African American community have allowed it to thrive even amid arduous circumstances.
This article discusses the African American social welfare system that began to develop during the early 20th century. This social welfare system, designed by African Americans to serve African Americans, addressed needs that were not being met by any other formal social services while the nascent social work profession was emerging. The myriad programs included settlement houses, boys and girls programs, training schools, and day nurseries. The women’s club movement played a critical role in the development of this social welfare system and provided much of the impetus for change and inclusion. Through formal organizations, including the National Urban League (NUL) and the Universal Negro Improvement Association (UNIA), and an array of clubs and social groups, social services were extended to urban and rural communities throughout the United States.
Colita Nichols Fairfax
Afrocentric social work is a concept and praxis approach applicable in environmental and global settings where people of African descent are located. Using concept analysis as a methodology, this article explores Afrocentric social work theory and its applicability in the social sciences. Concept analysis is an examination of a thought or theory with the intent to create a more concise operational definition. Afrocentric social work not only is applicable to racial and social justice issues, it also is applicable to intellectual and philosophical discourses of social work, which has largely ignored Afrocentric social work as a viable theory and philosophical canon. The Walker and Avant method of concept analysis is employed in this article to provide a systemic discourse to define the attributes of Afrocentric social work, as well as its structural elements that scholars and practitioners utilize as a theory and praxis application.
Older workers make important contributions to the workplace, its productivity, and its culture. Work remains important for older adults for financial security, to give meaning to later life, to maintain social networks, and to promote lifelong learning. However, ageist beliefs about the capacity of older adults to remain productive and contributing workers in the workforce can create barriers for older workers. Understanding how older workers experience ageist behavior in the workplace can help employers, policy makers, and social workers learn more about how to address this social problem. Organizations can become more age friendly through enabling workplace programs, supportive management, and proactive human resource managers. Social workers serving older adults in employee assistance programs and in private practice can help them to challenge ageism in the workplace. Finally, legislation such as the Age Discrimination in Employment Act protects the rights of older workers; however, more legislation is needed to address bullying and harassment of older adults in the workplace.
Retirement is a modest social institution that appeared in most industrialized nations near the start of the 20th century. The aim of retirement was to solve the societal dilemma of an increasingly aged labor force by moving older workers systematically out of their jobs so as to not cause them financial harm (Atchley, 1980, p. 264). Although retirement has been considered benign since its inception, the history of retirement indicates that it is one of the main progenitors of ageism in society today (Atchley, 1982, 1993; Haber & Gratton, 1994; McDonald, 2013; Walker, 1990). Retirement and its accompanying stereotypes have been used as a tool for the management of the size and composition of the labor force contingent on the dictums of current markets in any given historical era. Ever-changing ideologies about older adults that extend from negative to positive ageism have been utilized by business, government, the public, and the media to support whatever justification is required in a particular era, with little thought to the harm perpetrated on older adults. Unfortunately, society has subscribed to these justifications en masse, including older adults themselves. In this article the ageism embedded in retirement is examined to make what is implicit explicit to social work practitioners and policymakers in the field of aging.
Irwin Epstein and Stephen A. Kapp
This entry reviews agency-based research and the unique demands created by the organizational context where this activity resides. Three primary stakeholder groups are identified: administrators and program managers, supervisors, and direct service workers and clinicians. Possible uses of agency-based research by each of the respective stakeholder groups are described. Finally, the role of service consumers in agency-based research is discussed.
Nancy R. Hooyman and Amanda Barusch
The rapidly growing older population is more heterogeneous than any other age group. Although many face vulnerabilities and inequities as they age, most are resilient. This entry explores the “greying of America,” examines the definition and measurement of aging, reviews the diversity among older adults in the United States, discusses productive, successful, and active aging, and suggests leadership roles for social workers in enhancing the well-being of elders and their families.
Lenard W. Kaye
Social workers address older adult issues at all levels of service planning, policy-making, and delivery and across a wide range of community and institutional settings. While various models of practice intervention with older adults exist, more recently the focus is on the integration of micro and macro strategies with an emphasis on strength-based perspectives to geriatric social work practice. The older adult population will expand dramatically and become increasingly culturally, racially, and ethnically diverse in the future and social work services will need to be sensitive to the variety of issues faced by a more heterogeneous and sophisticated older adult population.
Jeanette C. Takamura
Public policy advances in the field of aging in the United States have lagged compared to the growth of the older adult population. Policy adjustments have been driven by ideological perspectives and have been largely incremental. In recent years, conservative policy makers have sought through various legislative vehicles to eliminate or curb entitlement programs, proposing private sector solutions and touting the importance of an “ownership society” in which individual citizens assume personal responsibility for their economic and health security. The election of a Democratic majority in the U.S. House and the slim margin of votes held by Democrats in the U.S. Senate may mean a shift in aging policy directions that strengthens Social Security, Medicare, and Medicaid, if the newly elected members are able to maintain their seats over time. The results of the 2008 presidential election will also determine how the social, economic, and other policy concerns will be addressed as the baby boomers join the ranks of older Americans.